Article
Impact of surgery on spinal metastatic disease – An analysis of 67 consecutive cases
Einfluss chirurgischer Therapie bei spinaler Metastasierung – eine Analyse von 67 konsekutiven Fällen
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Published: | April 23, 2004 |
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Outline
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Objective
A ten year experience of surgical intervention in spine metastases of various carcinomas is reported with respect to type of surgery and clinical outcome focussing on quality of life for the remaining survival period.
Methods
Of 346 patients with spinal extramedullary tumors treated surgically in our institution between 1/1993 and 12/2002, there were 67 patients with spinal metastatic disease from carcinomas. A retrospective analysis of this patient group was performed with regard to neurological pre- and postoperative status, type of surgery (decompression vs. decompression and stabilization), and quality of life as defined by pain control, ability to walk and continence.
Results
There were 33 women and 34 men. Mean age at surgery was 65,5 years. Mean follow-up was 12 months. 82 % presented with neurological deficits, 83,6 % with pain, 69 % with a combination of both. In 29 cases decompression and stabilization was performed, and the remaining 38 patients were solely decompressed. Excisional (gross total removal) surgery was performed in 48 %, all other cases had subtotal tumor removal or biopsies. Pain control could be achieved in 69,6 % of cases, neurological improvement was noted in 28 of 55 cases with preoperative deficit (51 %), whereas 2 patients worsened after surgery (3 %). Complications were seen in 7,5 %, recurrencies were treated surgically in 9 %. Mean survival time was 12 months, with 18 % longterm ( > 24 months) survivors, based on the data of 44 cases available for complete follow-up. Quality of life was positively influenced in 78 % of all patients, with no difference between types of surgery.
Conclusions
Surgery for spinal metastatic disease has a positive impact on the quality of remaining life in selected patients and with an individualized surgical regimen.